Infant 1yr

Figure 5.2 Iron need versus amount of recycled iron available. Table 5.5 O Stages of Iron Deficiency Anemia Matched to Diagnostic Signals Stage 1 Iron Stores Depleted. Test for Absence of stainable bone marrow iron Decreased serum ferritin level Increased TIBC Stage 2 Iron-Deficient Erythropoiesis. Test for Slight microcytosis Slight decreased hemoglobin Decreased transferrin saturation Stage 3 Iron Deficiency Anemia. Test for Decreased serum iron Decreased serum ferritin Increased TIBC one of...

O Troubleshooting

What Do I Do When the Lab Results Indicate That the Patient Is Not Responding to Heparin A coagulation sample from the intensive care unit was given to the laboratory on the evening shift. The patient had experienced multiple trauma due to an automobile accident. He had multiple fractures and internal injuries. His condition was grave. Heparin therapy was initiated as a result of the multiple trauma. The patient's admitting PT and aPTT was in the normal range PT 12.0 seconds (11 to 14 seconds)...

Tall

*These are example of chromosome abnormalities the list is not intended to be comprehensive. Figure 11.2 Acute myeloid leukemia with t(8 21) (q22 q22). Note Auer rod in myeloblast. *These are example of chromosome abnormalities the list is not intended to be comprehensive. ence texts for an in-depth discussion of immunophe-notypes and genetics that are characteristic for each disorder. Acute Myeloid Leukemia With t(8 21)(q22 q22) This leukemia occurs most often in children or young adults and...

Glucose6phosphate Dehydrogenase Deficiency

There are a limited number of inherited disorders of red cells related to biochemical deficiencies. Glucoses-phosphate dehydrogenase (G6PD) deficiency represents a fascinating and far-reaching disorder that has at its core a metabolic misstep. G6PD is the catalyst in the first stages of the oxidative portion of the red cell's metabolism and a key player is the phosphogluconate pathway, whose role it is to keep glutathione in the reduced state. Glutathione is the chief red cell antioxidant and...

Reticulocyte Procedure With Miller Eye Disc

A Miller Eye Disc is placed inside the microscope eyepiece as an aid to counting reticulocytes. This reticule is a large square inside a small square and provides the technologist the ability to isolate the reticulocytes while counting. 1. New Methylene Blue (Supravital Stain) 4. Microscope with Miller ocular eye disc 1. One EDTA tube or EDTA Microtainer 2. Specimens can be stored at room temperature for 8 hours or refrigerated at 2 to 8 C for 24 hours. Commercially prepared controls are...

Review Questions

One of the hallmarks in the diagnosis of a patient with CML is d. an M E ratio of 10 1 or higher. 2. The BCR ABL fusion gene leads to b. increased tyrosine kinase activity. 3. Blast crisis in CML means that there are more than _blasts in the peripheral smear 4. The origin of the dry tap in MMM occurs as a result of a. extramedullary hematopoiesis. b. the presence of teardrop cells in MMM. c. the infiltration of fibrotic tissue in MMM. d. the increase of megakaryocytes in MMM. 5. Thrombotic...

Quantitative Disorders Of Platelets

A normal platelet count is 150 to 450 X 109 L. In this range, an individual will have properly functioning platelets that assist in the coagulation process by creating a platelet plug and stimulating the formation of a solid fibrin clot. A decrease in platelet count will cause bleeding from the mucous membranes such as gum bleeding (gingival bleeding), nose bleeding (epistaxis), extensive bruising (ecchymoses), or petechiae (pinpoint hemorrhages). A patient with a platelet count of 60,000 will...

Review Questions fl

Which of the following are defects of platelet adhesion 2. Which one of the conditions will produce a thrombocytopenia due to an altered distribution of platelets 3. One of the main differences between TTP and HUS is d. microangiopathic hemolytic anemia. 4. Nose bleeding, deep bruising, and gum bleeding are usually manifestations of which type of coagulation disorder 5. The presence of thrombocytopenia and giant platelets best describes a. classic von Willebrand's disease. 6. Chronic idiopathic...

Hereditary White Cell Disorders

This inherited disorder is associated with thrombocytopenia and giant platelets. Abnormal bleeding may be seen in a small number of affected individuals. Dohle bodies are seen in the cytoplasm of neutrophils and are larger than the Dohle bodies seen in neutrophils responding to infections or inflammation. Alder's Anomaly (Alder-Reilly Anomaly) This rare genetic disorder is associated with the presence of coarse dark granules in neutrophils, lymphocytes, monocytes, eosinophils, and basophils...

Case Study

A 30-year-old woman was referred to the hospital for evaluation. She presented with a history of multiple spontaneous abortions. She is currently complaining of pain and swelling in her left thigh. Her family history and her past medical history were unremarkable. The patient is currently on oral contraceptives. The patient's laboratory results were as follows 8.0 X 109 L (Reference range, 4.4 to 11.0) 4.7 X 1012 L (Reference range, 4.1 to 5.1) 14.0 g dL (Reference range, 12.3 to 15.3) 43...

Dohle Bodies Vs Ehrlichiosis In Neutrophils

Toxic Granulation

Figure 10.2 The evolution of toxic granulation. Figure 10.3 Toxic granulation. Note heavier granulation throughout the cytoplasm. Figure 10.3 Toxic granulation. Note heavier granulation throughout the cytoplasm. Normal granulation in the segmented neutrophils shows a dustlike appearance, with the red and blue granules being difficult to observe. Toxic granulation is excessive granulation in amount and intensity, with more prominent granules in segmented neutrophils in direct response to...

Condensed Case

A 14-year-old girl had a tooth extracted and was noted to have unexpected bleeding following extraction. She bled for 24 hours before the bleeding could be stopped. The dentist recommended that she have a hematology evaluation for the unexpected bleeding. What questions concerning family history should be asked, and what baseline coagulation tests should be considered This patient is exhibiting signs of mucosal bleeding, the type of bleeding seen in platelet adhesion defects such as vWD and...

Red Blood Cell Membrane Development And Function

The mature red blood cell is a magnificently designed instrument for hemoglobin delivery. As a hemoglobin-filled sac, the red cell travels more than 300 miles through the peripheral circulation, submitting itself to the swift waters of the circulatory system, squeezing itself through the threadlike splenic sinuses, and bathing itself in the plasma microenvironment. Cellular and environmental factors contribute to red cell survival. In order for the red cell to survive for its 120-day life...

Comparing Acute And Chronic Leukemia

The initial evaluation of leukemia is initially made by 1. Noting the onset of symptoms 2. Analyzing the complete blood count CBC results 3. Observing the type of cell that predominates cell lineage 4. Assessing the maturity of cells that predominate Because leukemia is a disease of the bone marrow that causes normal bone marrow cell production to be crowded out as the abnormal, neoplastic cells take over, the CBC results will commonly show a decreased red cell count or anemia, as well as a...

Iron Storage And Recycled Iron

Fe2 And Ferritin

Ferritin and hemosiderin are the primary storage forms of iron. These compounds are harbored in the liver, spleen, bone marrow, and skeletal muscle. Ferritin can be measured in plasma, while hemosiderin is more often identified in the urine or stained through the bone marrow. Iron stores in men are generally 1.0 to 1.4 g of body iron, and for women, 0.2 to 0.4 g. Given these figures and with the realization that the iron absorption requirement is on average 1 mg day, it is easy to understand...

Performing A Manual Differential And Assessing Red Blood Cell Morphology

When blood samples are evaluated by the use of automated hematology analyzers, this analysis includes automated differentials. Specific criteria pertaining to normal, abnormal, and critical values have been programmed into the analyzers by the institution, and if the differentials do not meet these criteria, verification is necessary. This is done by performing manual differentials and further evaluating the peripheral smear. First, a differential white blood cell WBC count is performed to...

Peripheral Smear Procedure Principle

When automated differentials do not meet specified criteria programmed into the automated hematology instrument, the technologist technician must perform a manual differential count from a prepared smear. There are two types of blood smears the wedge smear and the spun smear. The wedge smear will be discussed in this procedure. Smears are prepared by placing a drop of blood on a clean glass slide and spreading the drop using another glass slide at an angle. The slide is then stained and...

Reactive Lymphocytosis In Common Disease States

Reactive Lymphocytes Pics

It is normal for young children between the ages of 1 and 4 to have a relative lymphocytosis. The white cell differential in this age group will show a reversal in the number of lymphocytes to segmented neutrophils from the adult reference range. The lymphocytes, however, will have normal morphology Fig. 10.11 . By far the most common disease entity displaying variation in lymphocytes is infectious mononucleosis. This is viral illness caused by the Epstein-Barr virus EBV , a member of the human...

Sickle Cell Procedure Principle

The sickle screen kit provides a procedure based on differential solubility. Hemoglobin S is insoluble when combined with a buffer and a reducing agent. This occurs when the blood is mixed with the buffer and sodium hydrosulfate solution. Specimens containing hemoglobin S are insoluble and show a turbid cloudy solution. Normal adult hemoglobin A is soluble and produces a transparent solution. The presence of hemoglobin S in either the heterozygous or homozygous state will produce a cloudy...

Acute Myeloid Leukemia

AML is malignant, clonal disease that involves proliferation of blasts in bone marrow, blood, or other tissue. The blasts most often show myeloid or monocytic differentiation. Almost 80 of patients with AML will demonstrate chromosome abnormalities, usually a mutation resulting from a chromosomal translocation the transfer of one portion of the chromosome to another .9 The translocation causes abnormal oncogene or tumor suppression gene expression, and this results in unregulated cellular...

The Microscope

The microscope is an essential tool to the hematology laboratory professional. It is a piece of equipment that is stylistically simple in design, yet extraordinarily complex in its ability to magnify an image, provide visual details of that image, and make the image visible to the human eye.2 Most commonly used today are compound microscopes, which use two lens systems to magnify the image. The ocular devices on the microscope provide an initial X10 magnification, and then additional...

Hematological Features Of Megaloblastic Anemias

The CBC shows a pancytopenia low white count, low red count, and low platelet count , although the platelet count may be only borderline low see normal values on the front cover of this textbook . Pancytopenia in the CBC combined with macrocytosis should raise the index of suspicion toward a megaloblastic process because few other conditions aplastic anemia, hyper-splenism show this pattern.4 Red cell inclusions such as basophilic stippling and Howell-Jolly bodies may be observed. Howell-Jolly...

Hematology in Practice

Betty Ciesla

Faculty, Medical Technology Program Morgan State University Baltimore, Maryland Assistant Professor Villa Julie College Stevenson, Maryland F. A. DAVIS COMPANY Philadelphia F A. Davis Company 1915 Arch Street Philadelphia, PA 19103 www.fadavis.com Copyright 2007 by F. A. Davis Company Copyright 2007 by F A. Davis Company. All rights reserved. This product is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means,...

Bacteria And Other Unexpected White Cell Changes

The presence of bacteria in a peripheral smear indicates bacteremia or sepsis, a condition that may have severe consequence to the patient. Blood is a sterile environment such that the presence of gram-positive or -negative bacteria, fungi, etc., is an unwanted event. Bacteria may be seen intracellularly or extracellularly as either cocci or rods. In either case, bacteria must be recognized and the significant medical caretakers must be alerted Figs. 10.15 and 10.16 . Precipitated stain may at...

Differentiate Extramedullary And Intramedullary Hematopoiesis

Hematopoiesis

Anticoagulant Agent that prevents or delays blood coagulation Pathophysiology Study of how normal processes are Protocols Formal ideas, plan, or scheme concerning patient care, bench work, administration, or research 1. Wintrobe M. Milestones on the path of progress. In Wintrobe M, ed. Blood, Pure and Eloquent. New York McGraw-Hill, 1980 1-27. 2. Abramowitz M. Microscope Basic and Beyond. Vol. 1. Melville, NY Olympus America Inc, 2003 1.25. 3. Wallace MA. Care and use of the microscope. In...